Healthy Life 2019 by Weeklys

HEALTHY LIFE

2019

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HEALTHY LIFE 2019

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Harwood Orthopedics

Dr. Harwood has provided state of the art orthopedic care to residents in the Bay Area for over 15 years. Specializing in sports related injuries, as well Dr. Harwood has provided state of the art orthopedic care to residents of the as chronic joint conditions, Dr. Harwood uses the latest research based medical South Valley for over a decade. Specializing in sports related injuries, as well technology to develop both operative uses and non-operative treatment as chronic joint conditions, Dr. Harwood the latest research basedplans. medical technology to develop both operative and non-operative treatment plans.  Minimally invasive knee, shoulder and hip replacement surgery  Minimally invasive knee,replacement hip and surgery shoulder reconstruction Biologic knee   

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THE ANNUAL CHECKUP Do You Still Need an Annual Doctor’s Visit?

f it’s true that an apple a day keeps the doctor away, then it seems like seeing the doctor for an annual physical exam ought to play a major role in keeping healthy people healthy. Yet most doctors now say it’s time to

rethink the notion of a yearly physical, a fixture in U.S. medicine since the 1940s.

HEALTHY LIFE 2019

Possible downsides of yearly checkups Studies done over at least 30 years have shown that for healthy adults— those who don’t have a long-term illness or take daily prescription medications— annual wellness checks don’t lower the number of deaths. They also don’t cut

the rates of disease-related deaths, hospitalizations, or the cost of care. “There’s not a ton of evidence that going in annually, if you’re healthy, prevents bad things from happening,” says Dr. Thomas Miller, chief medical officer for the University of Utah’s Hospitals and Clinics. Instead, studies from multiple researchers found the annual >6

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<4 exams can lead to the over diagnosis of some conditions, overtreatment, and to invasive, costly tests. That’s in part because some doctor payments are tied to the practice, and also because patients have come to expect them each year. Data from a national 2010 survey found that 21% of medical visits were for preventive care. Having a general medical exam was the No. 2 reason people went to the doctor. “It’s ingrained into our culture,” Miller says. “There’s a belief among some that it makes sense, so there’s always going to be a pool of folks who cherish the annual physical.”

Tips to strike a balance That’s not to say you should ignore preventive care altogether. For instance, it’s a wise idea to get your blood pressure and cholesterol checked. Your doctor can also help you work on healthy habits, like quitting smoking if you need to -- and that improves overall health, says Dr. Michael LeFevre. He’s the vice chair of family and community medicine at the University of Missouri, and the chair of the U.S. Preventive Services Task Force. So how, then, should health care consumers reconcile preventive services known to save lives against data that suggests an annual physical doesn’t matter much? “There are better ways to deliver preventive services then bringing people in once a year,” LeFevre says. “Better” means relying on the best and most current studies to figure out when testing makes the most sense. The task force, an independent panel of experts in prevention and evidencebased medicine, recommends age- or disease-specific screening tests instead of the once-a-year approach. For example, doctors first began recommending women be screened annually for cervical cancer about 50

HEALTHY LIFE 2019

years ago. This promoted the need for an annual doctor’s office visit. But now, women ages 21 to 65 need only have the tests every 3 years, LeFevre says. “These are the things that the science tells us help people live longer and live better,” he says. “What that requires is going to vary, based on individual circumstances, personal history, and age. I really do think it has to be individualized as opposed to saying everybody should get an annual physical.”

Tests you shouldn’t skip Blood Pressure: Every two years for adults with an ideal blood pressure below 120/80 points. Annually if your blood pressure is above 120/80. Breast Cancer: Mammogram every two years for women ages 50 to 74. Women at higher risk should talk to their doctor about getting screened before age 50. Cervical Cancer: Screening and pap

smear every three years for women ages 21 to 65. Human papillomavirus (HPV) testing every five years after age 30. Cholesterol: For most people, testing every five years is recommended, starting at age 35 for men and age 45 for women. Men and women at risk for heart disease should start getting screened at age 20. Colon Cancer: Screening for all adults between ages 50 and 75, usually every 10 years. Young, sexually active adults should also be screened for sexually transmitted infections, LeFevre says. Talk to your doctor about what tests you may need and how often. To make sure the testing gets done, Miller and LeFevre say they try to provide or schedule them when patients come in for other medical problems. The rules are different for people with ongoing medical problems. Both doctors say they like to see those patients at least once a year.

From WebMD

FITNESS AND EXERCISE

Fitness means being able to perform physical activity. It also means having the energy and strength to feel as good as possible. Getting more fit, even a little bit, can improve your health.

t’s a fact: You have to burn more calories than you eat and drink to lose weight.

For weight loss, it really matters that you cut back on the calories that you eat and drink. That matters most for taking the pounds off, according to the CDC. Exercise pays off in the long run by keeping those pounds off. Research shows that regular physical activity will increase your chances of maintaining weight loss.

HEALTHY LIFE 2019

How much exercise should i do? Start with just a few minutes of exercise at a time. Any exercise is better than none, and that helps your body slowly get used to being active. Your goal is to work up to at least a half an hour most days of the week to get the full benefits from exercise. If it’s more convenient, you can do short

spurts —10 minutes here, 15 minutes there. Each action by itself may not seem like much, but they add up. Once you’re in better shape, you can gradually exercise for longer periods of time and do more strenuous activities. When you’re up for it, you can ramp up the intensity and get the same benefits in half the time. For example, jogging for 30 minutes provides health benefits similar to walking for 60 minutes. > 10

What kind of exercise should i do? You can do anything that makes your heart and lungs work harder, such as walking, biking, jogging, swimming, fitness classes, or cross-country skiing. Mowing your lawn, going out dancing, playing with your kids -- it all counts, if it revs your heart. If you don’t exercise and you’re a man over 45, a woman over 55, or have a medical condition, ask your doctor if you should avoid any types of activities. Start with something like walking or swimming that’s easy on your body. Work at a slow, comfortable pace so you start to get fit without straining your body. At least two or three times a week, do strength training. You can use resistance bands, weights, or your own body weight. Stretch all your muscles at least twice

HEALTHY LIFE 2019

a week after you exercise. That helps keep you flexible and prevent injury.

which means they burn a lot of calories. In fact, they burn more calories than fat cells, even when you’re not exercising. So the time you spend working out reaps benefits long after you stop sweating.

How to boost your metabolism with exercise

How to start exercising

Your next workout could set you up for a speedier metabolism. Your metabolism includes all the things your body does to turn food into energy and keep you going. Some people have a faster metabolism than others. Some things that affect whether your metabolism is speedy or sluggish include things you don’t conßtrol, like your age, sex, and genes. Sometimes a sluggish thyroid could decrease your metabolism. But once you find out that it is normal, speeding it up is up to you. Focus on what really does make a difference: exercise. Muscle cells need a lot of energy,

First, think about what you’d like to do and how fit you are. What sounds like fun? Would you rather work out on your own, with a trainer, or in a class? Do you want to exercise at home or at a gym? If you want to do something that’s harder than what you can do right now, no problem. You can set a goal and build up to it. For example, if you want to run, you might start by walking and then add bursts of jogging into your walks. Gradually start running for longer than you walk. Don’t forget to check in with your doctor. He’ll make sure you’re ready for

2. Lift weights. Because muscle uses more calories than fat, strengthening your muscles will make you into a more efficient calorie-burning machine, even when you’re at rest. Twice a week, do one or two sets of 12 to 15 repetitions on each major muscle group (abs, biceps, glutes, quads). You’ll be doing more than just helping your metabolism. Your heart, bones, and even your mood will benefit. It’s a win all around.

Exercise for a healthy heart

whatever activity you have in mind and let you know about any limits on what you can do.

Types of exercise Your exercise plan should include: Aerobic exercise (“cardio”): Running, jogging, and biking are some examples. You’re moving fast enough to raise your heart rate and breathe harder, but you should still be able to talk to someone while you’re doing it. Otherwise, you are pushing too hard. If you have joint problems, choose a low-impact activity, like swimming or walking. Stretching: You’ll become more flexible if you do this a couple of times a week. Stretch after you’ve warmed up or finished exercising. Stretch gently -- it shouldn’t hurt. Strength training. You can use weights, resistance bands, or your own body

weight (yoga, for instance) for this. Do it 2-3 times a week. Let your muscles recover for a day between sessions. Exercise becomes even more important as you get older. You naturally lose muscle mass with age, which slows down your metabolism. Working out can stop that slide. It’s simple. You need to challenge your muscles often in these two ways: 1. Amp up your workout. Any kind of aerobic exercise, whether you’re running or doing Zumba, burns calories. Make it more intense, and your body will burn more calories. Try intervals. You can do them with any type of cardio. The basic idea is to switch back and forth between higher and lower intensity. You make it really challenging, and then back down your pace, and repeat. For example, do as many jumping jacks as you can for 1 minute, and then walk in place for 2 minutes. Repeat for 15 minutes.

Your heart is a muscle, and it gets stronger and healthier if you lead an active life. It’s never too late to start exercising, and you don’t have to be an athlete. Even taking a brisk walk for 30 minutes a day can make a big difference. Once you get going, you’ll find it pays off. People who don’t exercise are almost twice as likely to get heart disease as people who are active. Regular exercise can help you: • Burn calories • Lower your blood pressure • Reduce LDL “bad” cholesterol • Boost your HDL “good” cholesterol

Exercise precautions You’ll probably be able to exercise with no problem if your doctor says you can and if you pay attention to how you’re feeling while you’re working out. Stop and get immediate medical help if you have pain or pressure in your chest or the upper part of your body, break out in a cold sweat, have trouble breathing, have a very fast or uneven heart rate, or feel dizzy, lightheaded, or very tired. It’s normal for your muscles to be mildly sore for a day or two after your workout when you’re new to exercise. That fades as your body gets used to it. Soon, you might be surprised to find that you like how you feel when you’re done.

TYPE 2 DIABETES

Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes.

f you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.

In type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. At first, the pancreas makes extra insulin to make up for it.

HEALTHY LIFE 2019

But, over time your pancreas isn’t able to keep up and can’t make enough insulin to keep your blood glucose levels normal. Type 2 is treated with lifestyle changes, oral medications (pills), and insulin. When glucose builds up in the blood instead of going into cells, it can cause two problems: Right away, your cells may be starved for energy. Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart. Some people with type 2 can control their blood glucose with healthy

eating and being active. But, your doctor may need to also prescribe oral medications or insulin to help you meet your target blood glucose levels. Type 2 usually gets worse over time – even if you don’t need medications at first, you may need to later on. Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/ Pacific Islanders, as well as the aged population. > 14

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Diet and diabetes In the past, meal plans for people with diabetes were very restrictive. Things are different now. There isn’t a one-size fits all diabetes diet. While you may need to make some changes in what and how much you eat, you have flexibility in deciding what’s on the menu. With a little planning, you can still include your favorite foods. What does “healthy eating” really mean? • Eating a variety of foods, including vegetables, whole grains, fruits, non-fat dairy foods, healthy fats, and lean meats or meat substitutes. • Trying not to eat too much food. • Trying not to eat too much of one type of food. • Spacing your meals evenly throughout the day. • Not skipping meals.

Getting active Being active is another part of living healthy and managing diabetes. Any type of physical activity you do helps lower your blood glucose. Other benefits of physical activity include: • Having more energy • Relieving stress • Keeping your joints flexible • Lowering your risk for heart disease and stroke • Feeling great Talk to your doctor if you have questions about which activities are right for you. Examples of different types of physical activity include: • Aerobic activity (walking, biking, swimming) • Being active throughout the day (taking the stairs instead of an elevator) • Strength training (lifting weights or using resistance bands) • Flexibility exercises (stretching and yoga)

HEALTHY LIFE 2019

Aerobic activity Aerobic activity makes your heart and bones strong, relieves stress, helps your insulin work better and improves blood flow. For most people, it’s best to aim for a total of 30 minutes a day, at least 5 days a week. If you are trying to lose weight, you may want to exercise more than 30 minutes a day. Here are some examples of aerobic activity: • Take a brisk walk • Go dancing • Take an aerobics class • Swim or do water aerobics Go for a bike ride or use a stationary bike indoors. If you haven’t been very active recently, you can start out with 5 or 10 minutes a day and work up to more time each week. You can also split up your activity for the day: For example, take a quick 10-minute walk before or after each meal instead of 30 minutes all at once. In addition to aerobic activity, there are many ways to be more active during your day.

This can help you burn calories and lower your blood glucose. Here are some examples: • Walk instead of drive • Get off the bus a stop early and walk the rest of the way • Work in the garden, rake leaves or wash the car • Play actively with kids • Walk around while talking on the phone • Park at the far end of the lot and walk

Weight loss Your doctor or diabetes care team may suggest you try to lose some weight. Losing weight can improve your blood glucose, blood pressure and cholesterol. You don’t have to lose a lot of weight to start seeing results. Just losing 10-15 pounds can make a difference. There are many types of weight loss plans to choose from. Even using the Plate Method for meal planning can help with weight loss.

American Diabetes Association, diabetes.org

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Regenerative medicine in orthopedics

ecent medical breakthroughs have led to an exciting new area in medicine referred to as Regenerative Medicine. Regenerative Medicine is an emerging clinical approach using the power of stem cells to improve the repair and regeneration of damaged tissue. In other words, stem cells are used to heal the body, and can often eliminate or delay the need for surgery. Many acute and chronic orthopedic injuries, including joint pain, joint and tendon degeneration, and soft tissue injuries can be addressed using Regenerative Medicine. At Harwood Orthopedics, Maury Harwood, MD, offers two Regenerative Medicine alternatives including Stem Cells

and Platelet Rich Plasma (PRP) procedures. Stem Cell Therapy encompasses targeting areas of disease utilizing undifferentiated cells either from one’s own body or stem cells derived from amniotic fluid. Clinical scenarios for the use of Stem Cell Therapy include joint arthritis, tendon and muscle repair, orthopedic injuries, rheumatologic conditions and pain treatment. Stem cells have been shown to regrow cartilage, muscle and bone; reduce inflammation; promote cartilage growth; improve blood vessel formation; and recruit cells to repair/heal damaged tissue. Most commonly referred to as PRP, or Platelet Rich Plasma, is a technique whereby a small volume of blood is

concentrated through a centrifuge until the red blood cells and platelets separate. The resulting platelets are approximately 400% more concentrate and contain rich growth factors. This extraction is then injected into the desired area and stimulates the growth of collagen, which is the main component of connective tissue, (found in tendons) and cartilage. PRP contains many additional elements, including growth factors and powerful anti-inflammatory agents, which work symbiotically to aid in healing. Musculoskeletal areas that have a high rate of improvement using PRP include tendonitis in the elbow, knee, wrist and shoulder, as well as plantar fasciitis. To find out if your condition can be treated using Regenerative Medicine, book an appointment with Harwood Orthopedics located in Morgan Hill. ~ Sponsored content

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HEALTHY LIFE 2019

• Your sense of smell returns to normal. • Your breath, hair, and clothes smell better. • Your teeth and fingernails stop yellowing. • Ordinary activities leave you less out of breath (for example, climbing stairs or light housework). • You can be in smoke-free buildings without having to go outside to smoke. Quitting also helps stop the damaging effects of tobacco on how you look, including premature wrinkling of your skin, gum disease, and tooth loss.

Be safe in the sun

REDUCING CANCER RISKS

You can help reduce your risk of cancer by making healthy choices like eating right, staying active and not smoking.

Stay away from tobacco Quitting tobacco is not easy, but it can be done. Whether you’re a smoker, someone who uses smokeless tobacco, or someone trying to help a friend or loved one, you’ll find the information you need in this section. Quitting smoking lowers your risk of diabetes, lets blood vessels work better, and helps your heart and lungs. Life expectancy for smokers is at least 10 years shorter than that of non-smokers. Quitting smoking before the age of 40

HEALTHY LIFE 2019

reduces the risk of dying from smokingrelated disease by about 90 percent. Quitting while you’re younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke. Kicking the tobacco habit offers some rewards that you’ll notice right away and some that will show up over time. Right away you’ll save the money you spent on tobacco. And here are just a few other benefits you may notice: • Food tastes better.

Skin cancer is the most common cancer in the United States. In fact, more skin cancers are diagnosed in the US each year than all other cancers combined. The number of skin cancer cases has been going up over the past few decades. Most skin cancers are caused by too much exposure to ultraviolet (UV) rays. Most of this exposure comes from the sun, but some may come from manmade sources, such as indoor tanning beds and sun lamps. The good news is that you can do a lot to protect yourself and your family from UV rays, as well as to catch skin cancer early so that it can be treated effectively. You don’t need x-rays or blood tests to find skin cancer early—just your eyes and a mirror. If you have skin cancer, finding it early is the best way to make sure it can be treated with success. Everyone’s skin and eyes can be affected by the sun and other forms of ultraviolet (UV) rays. People with light skin are much more likely to have sun damage, but darker-skinned people, including people of any ethnicity, can also be affected. For some people, the skin tans when it absorbs UV rays. The tan is caused by an increase in the activity and number of melanocytes, the cells that make the pigment melanin. Melanin helps block out damaging UV rays up to a point, which is why people with naturally darker skin are less likely to get > 20

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< 18 sunburned, while people with lighter skin are more likely to burn. Sunburns can increase your risk of skin cancer, including melanoma. But UV exposure can raise skin cancer risk even without causing sunburn. Aside from skin tone, other factors can also affect your risk of damage from UV light. You need to be especially careful in the sun if you: • Had skin cancer before • Have a family history of skin cancer, especially melanoma • Have many moles, irregular moles, or large moles • Have freckles and burn before tanning Have fair skin, blue or green eyes, or blond, red, or light brown hair • Live or vacation at high altitudes (the strength of UV rays increases the higher up you are) • Live or vacation in tropical or subtropical climates • Work indoors all week and then get intense sun exposure on weekends • Spend a lot of time outdoors • Have certain autoimmune diseases, such as systemic lupus erythematosus (SLE, or lupus) • Have certain inherited conditions that increase your risk of skin cancer, such as xeroderma pigmentosum (XP) or nevoid basal cell carcinoma syndrome (Gorlin syndrome). • Have a medical condition that weakens your immune system, such as infection with HIV (the virus that causes AIDS) • Have had an organ transplant • Take medicines that lower or suppress your immune system • Take medicines that make your skin more sensitive to sunlight Ask your doctor, nurse, or pharmacist if you are taking any medicines that could increase your sensitivity to sunlig People who get a lot of exposure to ultraviolet (UV) rays are at greater risk for skin cancer. Sunlight is the main source of UV rays, but you don’t have to avoid the sun completely. And it would be unwise to stay inside if it would keep you from being active, because physical activity is important for good health. But getting too much sun can

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be harmful. There are some steps you can take to limit your exposure to UV rays. Some people think about sun protection only when they spend a day at the lake, beach, or pool. But sun exposure adds up day after day, and it happens every time you are in the sun. Simply staying in the shade is one of the best ways to limit your UV exposure. If you are going to be in the sun, “Slip! Slop! Slap!® and Wrap” is a catchphrase that can help you remember some of the key steps you can take to protect yourself from UV rays: • Slip on a shirt. • Slop on sunscreen. • Slap on a hat. • Wear sunglasses • Avoid tanning beds

Protect your children from the sun Children need special attention. They tend to spend more time outdoors, can

burn more easily, and may not be aware of the dangers. Parents and other caregivers should protect children from excess sun exposure by using the steps above. It’s important, particularly in sunnier parts of the world, to cover your children as fully as is reasonable. You should develop the habit of using sunscreen on exposed skin for yourself and your children whenever you go outdoors and may be exposed to large amounts of sunlight. Children need to be taught about the dangers of too much sun exposure as they become more independent. If you or your child burns easily, be extra careful to cover up, limit exposure, and apply sunscreen. Babies younger than 6 months should be kept out of direct sunlight and protected from the sun using hats and protective clothing. Sunscreen may be used on small areas of exposed skin only if adequate clothing and shade are not available.

American Cancer Society, cancer.org

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HEALTHY HEARTS

Heart disease is the No. 1 cause of death in the U.S. and stroke is No. 5.

early half of all U.S. adults have some type of cardiovascular disease, a percentage that reflects recently updated guidelines for treating high blood pressure, according to a new report. High blood pressure—also known as hypertension—can lead to heart attack, heart failure and stroke.

'We’re becoming more and more aware of the importance of high blood pressure. Levels we used to think were

22 HEALTHY LIFE 2019

normal we now associate with worse outcomes, and treating them makes a big difference,' said Dr. Emelia J. Benjamin, a professor of cardiology at Boston University and chair of the group that wrote the American Heart Association’s “Heart Disease and Stroke Statistics-2019 Update.” The report published in January in the AHA journal Circulation, has been released annually since 1958 and is based on data from the National Institutes of Health and other government sources. This year’s report

said 121.5 million adults in the U.S.—48 percent based on 2016 figures—have cardiovascular disease. Heart disease was the No. 1 cause of death in the U.S. and stroke was No. 5, the same ranking as in the previous year. The rise in cardiovascular disease is driven, in part, by changes in the way high blood pressure is defined. In November 2017, the AHA and American College of Cardiology updated the definition of high blood pressure as a reading of 130/80 millimeters of mercury, compared to the previous definition of 140/90. > 24

< 22 “We’ve made some real progress, but I think it’s important that we don’t do a victory lap. We still have to make sure all Americans have access to quality care and we have to continue to focus on Life’s Simple 7,” Benjamin said, referring to AHA’s seven goals of eating a healthy diet, exercising regularly, avoiding excess weight, not smoking, and keeping blood pressure, cholesterol and blood sugar within a healthy range. The update said tobacco use remains a leading cause of preventable death, accounting for 7.1 million deaths worldwide in 2016. While the report notes a “consistent decline” in smoking in recent years, it said there was a sharp increase in adolescents using e-cigarettes, which are now the mostused tobacco product in that demographic. “One of my great fears is that we’re addicting a whole new generation to nicotine with e-cigarettes,” Benjamin said. Past studies have shown nicotine can increase blood pressure and heart rate and cause narrowing of the arteries.

24 HEALTHY LIFE 2019

More Americans are becoming physically active, although the obesity epidemic is nowhere close to vanishing. According to the update, the prevalence of obesity was 39.6 percent of U.S. adults and 18.5 percent of youth, and severe obesity affected 7.7 percent of adults and 5.6 percent of youth. Obesity was associated with a shorter lifespan and a greater proportion of life lived with cardiovascular disease. “The overall prevalence of severe obesity in youth didn’t increase, but it’s still very concerning,” Benjamin said. “It’s a deeply disturbing condition and we have to ask, ‘What can we do about this?’” Dr. Gregg C. Fonarow, a professor of cardiovascular medicine and science at the University of California, Los Angeles who was not involved in writing the report, said the update should serve as a wakeup call for more Americans to be tested for cardiovascular diseases, especially high blood pressure. High blood pressure is sometimes

called the “silent killer” because it often lacks obvious symptoms. “Many are not aware their blood pressure is elevated,” said Fonarow. “High blood pressure is a major modifiable risk factor for heart attacks, heart failure, stroke, kidney failure and premature cardiovascular death. Achieving and maintaining a healthy blood pressure level can markedly lower the risk of these cardiovascular events for men and women, young and old, and all race-ethnic backgrounds.” Fonarow urged people with high blood pressure to treat it with lifestyle changes and, if needed, with blood pressurelowering medication. “This American Heart Association statistical update provides highly actionable data. The key question is whether clinicians and patients will actually act on it,” he said. “The nation’s future heart and brain health relies on that answer.”

American Heart Association, heart.org

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EVERY SECOND COUNTS

When stroke symptoms hit, every second counts. But not everyone calls 911 – a decision that has perplexed experts.

ow, a small study reveals some of the reasons. The research, presented this month at the American

Stroke Association’s International Stroke Conference in Honolulu, included interviews with 38 stroke patients who drove themselves or had someone drive them to Baptist Health South Florida Hospitals rather than calling 911. Lead researcher Maygret Ramirez said the most common reason, listed by nearly

26 HEALTHY LIFE 2019

one-third of participants, was hospital preference and not knowing where an ambulance would take them. Other reasons patients provided were not realizing it was an emergency, having a family member who preferred to drive, or thinking they would get to the hospital faster if they drove rather than waiting for an ambulance. “The fact that hospital preference is the number one reason for not calling 911 tells us we need to provide better education on this issue,” said Ramirez, a nurse practitioner at Baptist Health

Neuroscience Center in Miami. “People really need to understand that stroke can be a catastrophic event if not treated in time.” Patient concerns are not misguided. Guidelines recommend emergency medical teams take stroke patients to the nearest hospital that can deliver the clot-busting medicine alteplase. Ramirez said EMS teams are typically taught to refuse a patient’s request to go to a different hospital. Still, she said, that shouldn’t dissuade people from calling 911. If a patient > 28

If these signs are present CALL 9-1-1 HEART ATTACK SYMPTOMS

STROKE SYMPTOMS

Chest discomfort

Spot a stroke F.A.S.T.

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Face drooping Does one side of the face droop or is it numb? Ask the person to smile. Arm weakness Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Speech difficulty Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly? Time to call 9-1-1 If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Discomfort in other areas of the upper body Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath, with or without chest discomfort. Other signs, may include breaking out in a cold sweat, nausea or lightheadedness.

< 26 wants to go to a different hospital, “they could ask to be transferred (there) after the first assessment.” Fast action is essential in treating stroke, with early treatment leading to higher survival rates and lower disability rates. Yet previous studies have found more than one in three people who have a stroke don’t call 911 and instead rely on self-transport to get to the hospital.

Time is brain “We have to reinforce the idea that this is an emergency. We need more people to understand that when it comes to stroke, ‘time is brain,’ “ Ramirez said, repeating a phrase coined in the 1990s to amplify the message that the longer you wait to treat a stroke, the higher your chance of brain damage. Ramirez said she’d now like to see

28 HEALTHY LIFE 2019

research that looks at the specific types of educational messages that will get people to call 911 during a stroke. A stroke happens when blood vessels carrying oxygen to the brain are blocked or rupture, causing brain cells to die. In the U.S., stroke is the fifth most common cause of death. An estimated 140,000 people in the U.S. die of stroke each year. It’s also a leading cause of disability. Calling 911 for stroke is essential because it not only gets patients to the hospital faster but ensures patients are taken to a hospital that specializes in stroke treatment, according to the Centers for Disease Control and Prevention. Dr. Kevin Sheth, an associate professor of neurology and neurosurgery at Yale School of Medicine who was not involved in the new study, said he was surprised by the results.

“I’d have thought the main reason for not calling 911 would have more to do with misinterpretation of symptoms, not hospital preference,” he said. “And that raises some questions: What do we do about this? Do we need to provide more options for patients? Do we need to educate patients?” Sheth said he’s curious about whether socioeconomic and other factors such as race impacted whether people called for an ambulance. The findings are also limited by the small number of participants who were all treated at one hospital network in South Florida. “The question of ‘Why don’t we get patients to the hospital faster?’ is the biggest challenge in acute stroke research, but it’s a problem we have not made much of a dent on yet,” Sheth said. “Ultimately, we need to get more people to call 911 and get to definitive (stroke) therapy faster.”

From WebMD

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available for medicalâ&#x20AC;&#x201D;and, in some states, like California, for recreationalâ&#x20AC;&#x201D; purposes. What is the scientific evidence weighing the medical benefits of marijuana against its associated health risks: Is marijuana good or bad? What are the medical benefits of marijuana? Over the years, research has yielded results to suggest that marijuana may be of benefit in the treatment of some conditions, such as: Last year, a large review from the National Academies of Sciences, Engineering, and Medicine assessed more than 10,000 scientific studies on the medical benefits and adverse effects of marijuana. Chronic pain: One area that the report looked closely at was the use of medical marijuana to treat chronic pain.

BENEFITS OF CANNABIS

Chronic migraine: Marijuana, or products containing cannabinoids are effective at relieving chronic pain. Alcoholism and drug addiction: Marijuana may help people with alcohol or opioid dependencies to fight their addictions. However, the National Academies of Sciences review suggests that marijuana use actually drives

According to the National Institutes of Health, people have used marijuana, or cannabis, to treat their ailments for at least 3,000 years.

increased risk for abusing, and becoming

with marijuana use.

he Food and Drug Administration has not deemed marijuana safe or effective in the treatment of any medical condition, although cannabidiol, a substance that is present in marijuana, received approval in June 2018 as a treatment for some types of epilepsy.

30 HEALTHY LIFE 2019

Marijuana is being increasingly legalized in the U.S., but is it safe? This tension, between a widespread belief that marijuana is an effective treatment for a wide assortment of ailments and a lack of scientific knowledge on its effects, has been somewhat exacerbated in recent times by a drive toward legalization. Twenty-nine states plus the District of Columbia have now made marijuana

dependent on, other substances. And, individuals who began using the drug at a young age are also known to be at increased risk of developing a problem Depression, PTSD and anxiety: Marijuana could help to treat some mental health conditions. Marijuana could relieve depression and posttraumatic stress disorder symptoms. Cancer: Oral cannabinoids are effective against nausea and vomiting caused by chemotherapy.

Medical News Today

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